Those people who dedicate their lives to addressing stressors among displaced populations are frequently faced with an uncomfortable truth: people under a lot of stress sometimes create more problems for themselves. This is a well-observed phenomenon across populations, and is generally known as “stress generation.” As regards trauma work, there is good research to show that the best predictor of future trauma is past trauma. For those of you not well-versed in stress generation, see Constance Hammen’s reflection on her career researching stress generation among depressed individuals in the Journal of Clinical Psychology.

The uncomfortable part of all this is that it can move quickly into “blaming the victim” (particularly as it pertains to trauma). If a combat veteran presents with PTSD and marital conflict due to the irritability and anger that is a part of the PTSD diagnosis, it can be very difficult not to get really frustrated with that vet’s anger and sink into “it’s your own damn fault” despite our initial sympathy. An automobile accident survivor has a higher likelihood of getting into another automobile accident than someone who hasn’t been in an automobile accident because the survivors tend to be extra cautious following their first accident, drive more slowly at the wrong times, get distracted by other drivers, etc.; if these things cause an accident, who is responsible?

When it comes to refugees, blaming the victim may result in less critical aid from the international community and stigma upon resettlement. And yet it’s clear to anyone who’s worked in refugee camps that a stressed population is a difficult population is difficult to work with. Indeed, one of the impetuses behind bringing psychosocial interventions into humanitarian aid is the danger that stressed refugees can pose to aid workers. There are numerous reports of refugees striking out against aid workers for small irregularities in aid distribution or changes in policies. (I should add that their are also striking reports of other refugees coming to the aid of aid workers.)

So how do we reconcile stress generation with our discomfort? Well, first by reminding ourselves that the first order of health provision is not morality. (I’ve harped on that before, and you probably don’t need to read it again here.)

Second, by looking further into stress generation research so we know what we’re talking about. In this literature, folks like Hammen make the distinction between “dependent, interpersonal” stressors and “independent, fateful” stressors. It turns out that research with people with mental health diagnoses have (on average) more stress-dependent events than people without mental health diagnoses, but have the same number of independent events. Dependent events are almost uniformly interpersonal in nature — and therefore plausibly related to how one would act towards others if really stressed. Independent events may be interpersonal, but their core feature is their fateful nature — they are not affected by how someone is acting.

How does the dependent-independent dichotomy map on to the typology of conflict-related stressors proposed in the last entry in this blog? Well, it’s pretty clear that mental health problems aren’t to blame for people being attacked or cause them to end up in unstable resettlement contexts — this is the “direct war exposure potentially traumatic events (PTEs)” category. For “collateral” and “other PTEs” (which, as I think through them may not be as distinguishable as they first seemed), the picture is less clear, and that some of these stressors are related to “being stressed” means that education campaigns surrounding the affects of stress (at the very least) are important. “Social ecological stressors” are clearly set off by displacement, but the breakdown of community institutions may be exacerbated by interpersonal problems. This is why the “social” in “psychosocial intervention” has always struck me as the more important of the two traditions. “Daily hassles” are likewise split between those problems that are outside of the control of the individual (e.g., a military checkpoint) and those that are exacerbated (unemotional reactions to hearing of abuse of loved ones). So perhaps the dependent-independent dichotomy is a second axis that runs through the typology proposed a few days ago. (Again, comments encouraged here.)

Important to remember through all of this is that all of these stressors are precipitated by an initial event — the event that was the cause of displacement. It would be difficult to argue that displacement events were dependent stressors. And yet many subsequent stressors, be they mild or traumatic, are dependent to some degree. In order to address these, humanitarian aid workers must remember the latter, and the former; they are equally important.

Refugees made the front page of the Sunday New York Times this morning, and above the fold at that; but you might be surprised to learn the origin of the US’s fastest growing refugee population: Mexico. Drug wars in the northern state of Juárez along the border with Texas are sending thousands fleeing north.

In El Paso alone, the police estimate that at least 30,000 Mexicans have moved across the border in the past two years because of the violence in Juárez and the river towns to the southeast. So many people have left El Porvenir and nearby Guadalupe Bravos that the two resemble ghost towns, former residents say.

Similar to Colombia in the 1980s and 1990s, drug-related violence in Mexico has displaced thousands; unlike Colombia, many displaced Mexicans are seeking shelter outside of their country. Although a few incidents of drug-related violence have occurred on the US side of the Rio Grande, Texan border towns like El Paso and Fort Hancock remain remarkably peaceful. This combined with regional family ties and a long history of border crossings (and borders crossing; Texas to California and north to Oregon and Wyoming were, after all, part of Mexico for 300 years before they were part of the US) make fleeing north an obvious choice.

The Times article, written by James C. McKinley, Jr., presents several cases that will sound familiar to anyone who has worked with war-affected populations. New arrivals report sleep disturbances (and being able to get some sleep for the first time in weeks), pervasive anxiety symptoms, and that their children only play one repetitive macabre game, in this case called “sicarios” — hitmen.

So, are we welcoming Mexican forced migrants with open arms?

“This is an emergency situation, a war,” said Jorge Luis Aguirre, a journalist who himself has asked for asylum after his life was threatened in 2008 in Ciudad Juárez. “It’s a question of life and death for these people.”

But few Mexicans are granted asylum. Over the last three federal fiscal years, immigration judges heard 9,317 requests across the country, and granted only 183.

Fort Hancock has had a surge in applications in March and April, officials said. All told the number of people asking for asylum at ports of entry along the border alone has climbed steadily, to 338 for the federal fiscal year ended last October, from 179 two years before.

With much of the last twenty years spent preventing illegal immigration from Mexico, it is of course not surprising that immigration authorities would find asylum claims by all Mexicans suspect. But with the recent recession in the US, cross border immigration has decreased to some of the lowest levels in years. The refugees from the Mexican borderlands are not coming for economic reasons, they are running for their lives.

They are being met in this country by a harsh anti-immigrant and anti-Mexican climate. Not far to the west, the Arizona legislature has passed the most stringent immigration enforcement law in the US, one that asks and allows local police to determine whether someone is in US illegally using “reasonable suspicion” alone. Although police chiefs and civil libertarians (as well as immigrant advocacy groups) have spoken out against the bill, Governor Jan Brewer is expected to sign it into law within the next few weeks.

We usually think of displacement as an economically disempowering phenomenon. The residents flee from war or natural disasters with just the shirts on their backs, arrive in a new place without much in the way of orientation. How could anyone make any kind of money?

Last night on PBS’ News Hour, Adam Davidson of planet money presented a piece on the surprising economy of a displacement camp in Haiti. Evidently, the transformation from “collection of tents” to a real, functioning “tent city” has begun. There are evidently many good examples. Pedicures, for instance:

At the beginning, it was the basics, food, water, clothes. Then business expanded beyond the essentials. A week after the earthquake, Yoleen Samard went to her old salon, which had collapsed entirely, and rescued whatever beauty products she could. She brought them back.

Her husband cleaned out a space in their tent, and now she’s in business.

These customers, both 18 years old, say they can convince their parents to pay for a pedicure about every two weeks.

I once talked to a refugee kid from the Central African Republic living in a camp in southern Chad and asked him if he could do anything to make money. “I rent DVD’s.” Somebody had a DVD player and a generator, they sold tickets… so they needed someone to rent DVD’s.

None of this should make anyone think that displaced persons aren’t in desperate shape. But don’t assume that everybody’s just sitting around either. As I’m not an economist, I don’t know of any good research on what makes for relative success in displacement camps and what makes for “just sitting around,” but it seems to me a promising area of study for those interested in aid programming.

We usually think of displacement as an economically disempowering phenomenon. The residents flee from war or natural disasters with just the shirts on their backs, arrive in a new place without much in the way of orientation. How could anyone make any kind of money?

Last night on PBS’ News Hour, Adam Davidson of planet money presented a piece on the surprising economy of a displacement camp in Haiti. Evidently, the transformation from “collection of tents” to a real, functioning “tent city” has begun. There are evidently many good examples. Pedicures, for instance:

At the beginning, it was the basics, food, water, clothes. Then business expanded beyond the essentials. A week after the earthquake, Yoleen Samard went to her old salon, which had collapsed entirely, and rescued whatever beauty products she could. She brought them back.

Her husband cleaned out a space in their tent, and now she’s in business.

These customers, both 18 years old, say they can convince their parents to pay for a pedicure about every two weeks.

I once talked to a refugee kid from the Central African Republic living in a camp in southern Chad and asked him if he could do anything to make money. “I rent DVD’s.” Somebody had a DVD player and a generator, they sold tickets… so they needed someone to rent DVD’s.

None of this should make anyone think that displaced persons aren’t in desperate shape. But also don’t make the assumption that everybody’s just sitting around either. As I’m not an economist, I don’t know of any good research on what makes for relative success in displacement camps and what makes for “just sitting around,” but it seems to me a promising area of study for those interested in aid programming.

When people think about countries with lots of refugees, they usually don’t think about Colombia. But according to the United Nations High Commissioner for Refugees, Colombia is number three on the list of nations with displaced people. Unlike other large displaced populations, however, Colombia’s half-million refugees aren’t really technically refugees, as the vast majority of them do not cross the border out of Colombia; in the language of international law, they remain internally displaced persons, or IDPs. In fact, although number three on the list of displaced persons worldwide — number one and two are Afghanistan and Iraq, in case you were wondering — Colombia has the most IDPs anywhere.

The research on IDPs generally shows that they are worse off than refugees as they remain in harm’s way. But as the civil war in Colombia has wound down, a few of Colombia’s IDPs are beginning to find ways to make their way home. A friend recently sent me a link to a series of video reports on one community’s efforts to go home (hat tip to Lina Villegas). This series (which is in Spanish) revolves around the efforts of women in Mampujan, a small town in northwest Colombia that was the site of a massacre on March 11, 2000.

This story illustrates a few important factors in the story of restoring displaced communities: story telling — here using beautiful quilts — land reclamation, and a few frames on the intimate relationships people develop with homes and common spaces like schools and businesses. I encourage you to watch the series, even if your Spanish isn’t very good. It is as illustrative as it is inspiring.